Title: Case Manager
Department: Care Coordination
Type: Full Time
Location: Alamogordo, NM
Part 2 of Kerry Bolin, RN Video:
What's Unique in Care Coordination?
About the Position
Provides for the development, coordination, and implementation of care coordination services over the continuum of care. The position will incorporate the traditional functions of Discharge Planning, Quality, and Utilization Management with a focus on high-risk inpatient populations.
- Demonstrates knowledge and skills necessary to provide services based on the physical, psychosocial, educational, safety, and other related criteria for appropriate population in his/her assigned area.
- Submits appeals in a timely manner, upon request by the Director.
- Initiates discharge planning on assigned patients within 24 hours of admission. Revises discharge planning as indicated by changes in the patient’s condition and circumstances.
- Arranges for the post-discharge needs of patients.
- Clearly and accurately documents all patient/family interventions and interactions.
- Monitors for the efficient use of resources and reports to Director when there are actual or potential sources of under- or over-utilization.
- Collaborates with providers, nurses, patients, families, and other care providers in the development and implementation of patient care plans, including discharge planning, across the continuum of care in support of the GCRMC Mission.
- Communicates with providers regarding patient status and assists him/her in ensuring proper placement of patient.
- Conducts utilization review using nationally recognized medical necessity criteria and documents the review.
- Refers cases for second level reviews when medical necessity criteria are not met.
- Demonstrates familiarity with the various levels of care and community resources available for each patient and the providers of these different aspects of care.
- Actively participates in interdisciplinary treatment planning rounds.
- Utilizes innovative methods to facilitate development and implementation of discharge plans.
- Makes self available as resource to nursing staff. Provides learning experiences to strengthen and expand the staff’s expertise.
- Participates in infection control activities by screening, monitoring, and reporting individual cases and/or trends to the infection control nurse.
- Performs utilization management functions as required by payer source.
- Complies with the Utilization Management Plan.
Click on video above to know what Kerry Bolin, RN, Director of Care Coordination at Gerald Champion has to share about the Department
- Bachelor’s degree in Nursing or three + years of experience in nursing preferred but other health care related education may be considered based on experience. Experience in Care Management preferred.
- Licensure: If a Registered or Licensed Practical Nurse Currently Licensed to Practice in the State of New Mexico.
- Other disciplines, licensure as required by State of New Mexico.
- Certification: Current American Heart - Basic Life Support (BLS) card.
- Five years recent relevant clinical experience in an acute care facility required.
- Strong patient education abilities.
- Knowledge of the regulatory environment, including Medicare Conditions of Participation, DNV standards, HIPAA, and reporting requirements.
- Health Insurance
- Life Insurance
- Dental/Vision Insurance
- Long Term Disability
- Aflac Supplemental Insurance
- Relocation Assistance
- 401K matching
- Direct Deposit
- Generous PLT (Paid Leave Time)
- Major Medical Bank (Paid Sick Time)
- Holiday Pay
- Rewards and Recognition
- Eligibility to Qualify for the Daisy Award
- Merit Increases/Evaluations
- Clinical Ladder
- Referral bonus
- Long service bonus
- Holiday parties
- Free meal in the cafeteria
- Employee of the Month
- Employee Assistance Program
- Retail Discounts for Employees
About Gerald Champion Regional Medical Center
Since 1948, Gerald Champion Regional Medical Center (GCRMC) has been a healthcare leader for the citizens of Otero County. Our mission is simple. We want to be the organization where patients choose to come for care, physicians want to practice, and people want to work. Ultimately, we want to be South Central New Mexico’s leading provider of affordable, high quality healthcare. At GCRMC, we provide an environment for our employees that encourages innovation and dedication, via a participative management system and one that correlates performance and rewards.
GCRMC is an Equal Opportunity Employer that welcomes and encourages diversity in the workplace.
Apply today. Our short application process takes less than 5 minutes with your phone, tablet or computer.